不同囊胚活检方法用于植入前遗传学检测的临床效果  

Clinical effect of biopsy methods of different blastocyst

作　　者：宋歌 米冬青[1] 蒋彦[1] 田耕 袁景川[1] 耿彩平 苗穗兵 吴小华 SONG Ge;MI Dongqing;JIANG Yan;TIAN Geng1;YUAN Jingchuan;GENG Caiping;MIAO Suibing;WU Xiaohua(Shijiazhuang Obstetrics and Gynecology Hospital Affiliated to Hebei Medical University, Shijiazhuang,Hebei Province, 050011)

机构地区：[1]河北省石家庄市妇产医院(河北医科大学附属妇产医院),050011

出　　处：《中国计划生育学杂志》2021年第9期1831-1835,共5页Chinese Journal of Family Planning

基　　金：石家庄市科学技术研究与发展计划(191201173)。

摘　　要：目的:比较胚胎植入前遗传学检测技术(PGT)中两种囊胚活检方案的临床效果。方法:对2019年1月—2020年6月在本院接受PGT患者的临床资料进行回顾性分析,比较第3天(D3)打孔活检法(D3打孔活检组)D5打孔孵出与D6皱缩后活检相结合的方法(新D5/D6活检组)的结局。结果:女方年龄(30.1±3.6)岁,共75个PGT周期,其中染色体病63周期,单基因病6周期,复发性流产6周期。活检囊胚348枚,检测成功339枚,活检成功率97.4%。PGT检测正常囊胚率41.9%(142/339)。45例患者共移植51个周期,临床妊娠率64.7%(33/51)。D3打孔活检组的囊胚形成率低于新D5/D6活检组(64.8%比72.0%,P=0.034),可利用囊胚形成率低于新D5/D6活检组(63.7%比73.0%,P=0.025)。两组D3优胚率、D3可用胚胎率、临床妊娠率无差异。结论:D5打孔孵出/D6皱缩后活检相结合的方法较D3打孔活检法可获得更好的囊胚形成率和可利用囊胚率。Objective:To compare the clinical effect of two blastocyst biopsy protocols used in preimplantation genetic testing(PGT).Methods:A retrospective analysis was conducted on the clinical data of the women who had received PGT from January 2019 to June 2020.The outcomes of the women were compared between group A and group B.The blastocyst of the women in group A was punch biopsy on the 3rd day(D3)and the blastocyst of the women in group B were punch hatching punch on the 5th day(D5)combined with the shrinkage blastocyst were biopsy on the 6th(D6).Results:The average age of these woman was 30.08±3.63 years old.There were 75 PGT cycles,which included 63 cycles of the women with chromosomal diseases,6 cycles of the women with monogenic diseases,and 6 cycles of the women with recurrent miscarriage.348 blastocysts were biopsied,and 339 were successfully biopsied with the biopsy success rate of 97.4%.The rate of normal blastocysts detected by PGT was 41.9%(142/339).There were 51 cycles of blastocysts transplantation in 45 women,and which clinical pregnancy rate was 64.7%(33/51).The blastocyst formation rate(64.8%)of the women in group A was significant lower than that(72.0%)of the women in group B(P=0.034),and the available blastocyst formation rate(63.7%)of the women in group A was significant lower than that(73.0%)of the women in group B(P=0.025).There were no significant differences in D3 optimal embryo rate,D3 available embryo rate,and clinical pregnancy rate of the women between the two groups.Conclusion:Compared with those of the method of D3 punch biopsy of blastocyst,the blastocyst formation rate and the usable blastocyst rate of the method of D5 punch hatching of blastocyst combined with D6 shrinkage biopsy of blastocyst are better.

关 键 词：胚胎植入前遗传学检测 囊胚培养 滋养层细胞活检 激光破膜 囊胚孵出 

分 类 号：R71[医药卫生—妇产科学]